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Quality Accounts 2018-19

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Quality Accounts 2018-19 Quality Accounts 2018-19 This Quality Account covers the period 1 April 2018 to 31 March 2019 101 Contents Part 1 – Letter from our Chief Executive Part 2 – Our Priorities About us Our patient safety priorities Quality Account priorities – looking back over the last year Quality Account priorities - Looking forwards to this year Statements of assurance from the Board of Directors Part 3 – Other information Reporting against core indicators CQC CQUIN Duty of Candour Additional considerations Annex 1: Statements from commissioners, local Healthwatch organisations and overview and scrutiny committees Annex 2: Statements of directors’ responsibilities for the quality report 102 Glossary of terms Assessment and Comprehensive ACE OPU Evaluation Older Person’s Unit MSK Musculoskeletal ACS Acute Coronary Syndrome National Safety Standards for Invasive NatSSIPS Procedures ARK Antibiotic review kit NEWS National Early Warning Score AKI Acute Kidney Injury NHS National Health Service ASP Antiphospholoipd Syndrome National Health Service England / NHSE/I Improvement BANES Bath and North East Somerset National Institute for Health and Care NICE Excellence BIU Business Intelligence Unit NTC Neonatal Transitional Care BAPM British Association of Perinatal Medicine PALS Patient Advise and Liaison Services CCG Clinical Commissioning Group PROMS Patient reported outcome measure C.diff Clostridium difficile Q1 Quarter 1 (April, May, June) CQC Care Quality Commission QI Quality Improvement Quality, service improvement and CQUIN Commissioning for Quality and Innovation QSIR redesign DTT Decision to Treat RCA Root Cause Analysis EAP Employee Assistance Program RCEM Royal College of Emergency Medicine National Emergency Care Intensive Support ROP Retinopathy of Prematurity ECIST Team RUH Royal United Hospitals E. Coli Escherichia coli ED Emergency Department RTT Referral to treatment FFFAP Falls and Fragility Fracture audit program SAU Surgical Admissions Unit FFT Friends and Family test SHMI Summary Hospital level mortality Indicator FLS Fracture Liaison service SJR Structured Judgment Review Health Education England South West HEESWSN Simulation Network SKIP Sepsis and Kidney Injury Prevention HMSR Hospital Standardised Mortality Ratios SSNAP Sentinel Stroke National Audit Programme HSJ Health Service Journal SPR Specialist Registrar SSB Sugar sweetened beverage IM&T Information Management and Technology Local Safety Standards for Invasive STP Sustainability and transformation plan LocSSIPS Procedures SWAST South West Ambulance Service MAU Medical Admissions Unit UTC Urgent Treatment Centre MDT Multi-Disciplinary Team MRSA Methicillin Resistant Staphylococcus Aureus VTE Venous thromboembolism MOP Minor Operating Procedures West of England Academic Health WEAHSN Science Network 103 Part 1 Letter from our Chief Executive 104 Quality Accounts 2018-19 Part 1: Chief Executives Statement –statement on quality The Board of Directors is committed to providing services of the highest quality to our patients, their families and carers and to being a listening organisation that is responsive to individual needs. As an organisation we strive to place patient safety and service improvement at the heart of everything we do. We aspire to be a good partner: innovative, collaborative and passionate about patient experience, and we work closely with service users, their carers, our partners in other agencies and third sector colleagues to deliver integrated care across our local system. The Trust values: Everyone Matters, Working Together, Making a Difference are at the core of everything we do for our patients, and represent our aspiration for the type of hospital we strive to be. The Trust identifies a series of quality priorities each year, and I am pleased to report that we made substantial progress against our quality priorities for 2018/19 as described in the accounts below. The Trust is proud of its dedicated staff, and I am delighted to report that several teams have been recognised for their outstanding work and nominated for a number of awards in 2018/19. This reflects the commitment of our staff to deliver the highest quality of care. This has included, amongst many others: - Our Home First partnership team named as regional winners in the National NHS70 Parliamentary Awards. The Home First scheme was launched by the Trust in 2017 and aims to reduce the length of stay for patients who are clinically well enough to leave hospital, but who might need extra support to return to their usual place of residence; The Royal United Hospitals’(RUH) specialist Sleep team, and Pulmonary Hypertension care service both shortlisted in this year’s British Thoracic Society awards; Three pioneering projects from the Trust shortlisted as Health Service Journal (HSJ) Award finalists which celebrate excellence and innovations throughout the health service, including a patient safety project introducing screening tools to identify patients at risk of sepsis and acute kidney injury (AKI) and a nomination for establishing a national quality improvement training programme for staff at the RUH. Staff from our Project SEARCH team were also recognised in the Widening Participation category and went on to win at the Awards Ceremony on 21st November 2018. This category recognises organisations who make efforts to recruit from groups and communities who aren’t well represented in the NHS workforce, have had trouble finding employment elsewhere or that have specific needs and 105 experiences. Project SEARCH is a one-year course supported by the Trust, in partnership with Virgin Care and Fosse Way School, which helps students with learning disabilities to gain work experience and find jobs; The Trust received a commendation at the 2018 Quality in Care (QiC) Diabetes Awards for its work in helping children manage their diabetes; and Our multi-award winning Frailty Flying Squad were named winners for the 5127 Award at the 2018 Fab Awards on 17-18th November. The pioneering specialist team of doctors, nurse practitioners and therapists work in the Trust’s Emergency Department and Medical Assessment Unit and identifies older patients who, with some intensive assessment and treatment, have the opportunity to return to the community rather than being admitted to hospital. Like many other acute trusts this year, we have been facing huge pressures on our Emergency Department (ED) with increasing admissions and a higher than the national average elderly population. With our partners we have focused on reducing long lengths of stay in hospital and this year we have seen a month on month reduction in the number of patients staying over 21 days in hospital (24% reduction from 2017/2018). This means that patients leave hospital when they are ready to and avoid any unnecessary delays. We remain committed to delivering high quality safe care to our patients at all times, and we recognise the impact that periods of continued pressure have both on our patients and staff. I would like to take this opportunity to thank our staff for their dedication and support throughout the year. We also continue to work in a more efficient and effective manner, make savings and meet efficiency targets while still providing quality care to our patients. The Trust has established a programme of work that will support us in the delivery of sustainable highest quality services to our patients and enable us to be an employer of choice through our particular focus on staff engagement and wellbeing. This exciting four-year programme is called "Improving Together" and will focus on creating a culture of service improvement across our hospitals at all levels, and ensuring that front- line clinical staff are empowered to effect change and improvements to the services they provide. The work will deliver our vision and key objectives for patient safety and quality, staff satisfaction and sustainability. I confirm that to the best of my knowledge the information in these quality accounts is accurate, and I hope that you find it interesting and informative. I would welcome any feedback you would like to share. Signed: James Scott Chief Executive Date: 10/05/2019 106 Part 2 Our Priorities 107 Part 2: Priorities for Improvement and statements of assurance from the Board of Directors 2.1 About Royal United Hospitals Bath NHS Foundation Trust The Royal United Hospitals Bath NHS Foundation Trust (the Trust) primarily provides healthcare services to around 500,000 people across Bath and North East Somerset, Wiltshire, Somerset and South Gloucestershire. Our dedicated workforce of clinical and non- clinical staff deliver a range of high quality services from our main major acute hospital site in Combe Park in Bath, the Mineral Water Hospital in central Bath, and a number of community birth centres and other outpatient centres across the region. The Trust provides around 760 beds, a comprehensive range of acute services, including medicine and surgery, services for women and children, accident and emergency services, specialist rehabilitation services, and diagnostic and clinical support services. The Trust, in partnership with local universities and colleges, also plays a significant role in education and research. Doctors, nurses and many other healthcare professions have been with us as students and have stayed with us as qualified staff. This focus on learning supports innovation and improvement in the excellent care provided for our patients. The Trust continues to work collaboratively with system partners across the local
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